PT  - JOURNAL ARTICLE
AU  - KW Phang
AU  - H Bilolikar
TI  - G378(P) Alopecia totalis associated with subclinical hypothyroidism in a child with Trisomy 21
AID  - 10.1136/archdischild-2016-310863.368
DP  - 2016 Apr 01
TA  - Archives of Disease in Childhood
PG  - A220--A221
VI  - 101
IP  - Suppl 1
4099  - http://adc.bmj.com/content/101/Suppl_1/A220.short
4100  - http://adc.bmj.com/content/101/Suppl_1/A220.full
SO  - Arch Dis Child2016 Apr 01; 101
AB  - Aim To highlight the rarity of Alopecia Totalis in Trisomy 21 and a possible association with subclinical hypothyroidism.Method A 2 year old boy with known Trisomy 21 presented with a sudden onset of Alopecia Totalis – beginning with a lightening of hair colour followed by rapid hair loss (Figures 1 and 2) – with no apparent trauma, infection, change in medication or other symptoms. A full clinical examination was carried out on presentation with no findings other than the Alopecia Totalis and features of Trisomy 21. A persistently raised TSH was noted following investigations. Anti-nuclear antibody and thyroid peroxidase antibodies were negative. The Alopecia Totalis persisted with no spontaneous recovery. A small dose of thyroxine 25 micrograms was commenced in view of the persistently raised TSH.Abstract G378(P) Figure 1 Abstract G378(P) Figure 2 Results TSH reverted to normal with the commencement of Thyroxine. In addition, hair growth appeared on the eyebrows and for a few months on the scalp before falling away again.Conclusion Alopecia Totalis is a rare clinical finding in children. Limited hair loss, (Alopecia Areata) has been reported in children with Trisomy 21, with a possible association of hypothryoidism. A literature search did not identify any reported cases of Alopecia Totalis in a child with Trisomy 21 and concurrent hypothyroidism. Causation and management remains unclear. Investigations for possible hypothyroidism may be useful in managing this rare condition.